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Minimally-Invasive Knee Surgery by Dr Robert J Snyder MD

By Orthopaedic & Spine Center

Arthroscopic knee surgery is almost always done as an outpatient procedure, unless the patient has other medical conditions that may predicate their being admitted to the hospital for post-surgical monitoring for a longer period. I will have the patient report to the Ambulatory Surgical Center at a predetermined time for their surgery, where they will be prepped and sedated for the procedure. Currently, I tend to order short-acting anesthesia that is more easily tolerated by patients and reduces that groggy and foggy feeling after surgery. We will supplement the anesthesia by injecting a long-acting pain reliever around the knee during surgery, and by keeping the patient on a variety of oral medications at home after surgery.

When the patient is sedated, I begin the surgery by inserting the arthroscope into the knee, through a small incision, and making a second, small incision, through which I insert surgical instruments. Once I can see the entire knee through the fiber-optic camera, the operative part of the procedure begins – perhaps removing or repairing a torn meniscus, or reconstructing a torn ACL.

When the surgery is complete, the patient is taken to an outpatient recovery room to fully awaken and to be monitored by the staff for any signs of complication. In my experience, most outpatient arthroscopic knee surgeries take about 45 minutes to an hour, although some can be completed in as little as 30 minutes. Oftentimes, it only takes several hours from check-in to discharge for these arthroscopic procedures.

After surgery, patients are wheeled to the recovery room where recovery room nurses monitor them until they are fully alert. When the patient is fully awake, alert and stable, I will check in on them to make sure they are doing well after surgery. I will ask them if they feel any pain or nausea. As someone must accompany as patient to and from the surgical procedure, I usually review with this person a list of post-surgical instructions, including what prescriptions to take and how to take them. Typically, patients go home on a narcotic pain medicine, such as Percocet, which may be supplemented with Tylenol and Aleve, which they take on a regular basis. Preoperatively, I show patients exercises to do until they are seen in the office a week after their surgery. We will have already discussed issues such as bathing, showering and how to use their crutches. When I deem the patient ready, I send them home to rest and recover.

In my next post, I will explain how recovery progresses for a patient who has had arthroscopic surgery.

Robert J. Snyder is an Orthopaedic Surgeon who specializes in the treatment of knees, hips and shoulders. A graduate of and former Chief-of-Surgery at the United States Military Academy at West Point, Dr. Snyder’s specialty focus is Total Joint Replacement and the treatment of Sport Injuries.